Effect of tranexamic acid in traumatic brain injury: a case report

Toru Miike, Yuichiro Sakamoto, Satoshi Inoue

J Nippon Med Sch 2020 Apr 30;Online ahead of print.

Traumatic brain injury (TBI) often results in coagulopathy, which increases mortality risk. The clinical randomization of an antifibrinolytic in significant head injury (CRASH) -2 and CRASH-3 trials confirmed that tranexamic acid (TXA) was effective after trauma. Herein, we report a unique coagulation change in a patient with TBI given TXA after point-of-care assessment.

Coagulation functions were impaired on admission. At 1 hour after TXA administration, clotting time was further prolonged in the extrinsic coagulation pathway but shortened in the intrinsic coagulation system. The results of a total thrombus-formation analysis system test showed improved blood clot formation ability. Intrinsic coagulation and clot formation improved after TXA administration in a TBI patient with coagulopathy.